This study aims to define the usefulness of antibiotic prophylaxis of urinary tract infection (UTI) in postmenopausal female undergoing invasive urodynamics (IU). Two hundred sixty-two postmenopausal females underwent IU. Before urodynamics, all females were double blindly randomized in two age stratified groups. Group 1 (130 patients) received oral antibiotic prophylaxis with a single 400-mg dose of norfloxacin. Group 2 (132 patients) received norfloxacin placebo. Statistical analysis was performed by a chi (2) test to evaluate differences between groups for UTI incidence rate. Fifty-four patients of 262 (20.6%) resulted affected by UTI [24 of 130 subjects who received antibiotic prophylaxis (18.4%) and 30 of 132 subjects who received placebo (22.7%)]. There was no statically significant difference (P = 0.242) regarding UTI incidence rate between patients who received and those who did not received antibiotic prophylaxis. UTI incidence rate in postmenopausal women undergoing urodynamics is not affected by administration of antibiotic prophylaxis at the desired level of efficacy.
Study design: Prospective study. Objectives: To evaluate the feasibility of color ultrasound imaging of the urethra in association with UPP to diagnose intrinsic sphincter de®ciency (ISD). Setting: Italy. Methods: We studied a group of 13 normal female volunteers (mean age 29 years) during the estrogenic phase and a group of 15 patients (mean age 63.9 years) with ISD. All patients and normal volunteers underwent color ultrasound imaging using a 4 ± 7 MHz convex broad band transducer. Translabial sagittal scans of the urethra were obtained. The color ultrasound parameters were optimized for detection of parenchymal slow¯ows. A subjective score of the degree of vascularization along the entire urethra was established as follows: (a) minimal or absent (1), (b) poor (2), (c) moderate (3), (d) good (4). Statistical analysis, using the nonparametric Mann-Whitney rank sum test, was carried out to determine di erences of ultrasound scores between volunteers and patients. Results: The statistical evaluation showed that the di erences between the ultrasound scores in the two groups was statistically signi®cant (P50.001). Conclusion: We a rm that color ultrasound imaging of the urethra seems to be feasible and useful in association with UPP in the diagnosis of ISD even if this echographic investigation needs further observations.
Introduction. We analyzed efficacy and complications of extracorporeal shock wave lithotripsy (SWL) and analgesia requirement during the treatment in two groups of patients treated with different lithotripters. Materials and methods. The patients treated were 189, 102 between September 2016 and April 2017 with HMT Lithotron® LITS 172, electrohydraulic, and 87 between May and September 2017 with Storz Medical Modulith® SLK, electromagnetic. The main differences between the lithotripters are: type of energy source, patient position, frequency and number of shock waves. All the patients underwent sonography before and four to eight weeks after the treatment. The targeting was sonographic for renal stones and X-ray for ureteral stones. All the patients received Ketorolac before the treatment with a supplement of Pethidine if needed. People lost to follow-up and with incomplete data were excluded. Results. We enrolled 173 patients, 94 treated with the electrohydraulic lithotripter and 79 with the electromagnetic one. 43 patients (54%) in the electromagnetic group and 31 (33%) in the electrohydraulic group were stone free or presented clinically insignificant residual fragments (CIRFs), defined as asymptomatic, noninfectious, ≤ 3 mm. The association between CIRFs and the kind of lithotripter was statistically significant (p = 0.004). An increased need for analgesia was found in 14.9% of patients in the electromagnetic group and in 81% of patients in the electrohydraulic group (p < 0.001). The access to emergency room (intractable pain, kidney failure, fever, Steintrasse) after the treatment was similar in the two groups (p = 0.37). Conclusions. The best results in stones fragmentation and less analgesia requirement were demonstrated in the electromagnetic lithotripter group. No differences were demonstrated considering the need for emergency room after the treatment
Introduction: Nephron-sparing surgery (NSS) is of one of the most studied fields in urology due to the balancing between renal function preservation and oncological safety of the procedure. Aim of this short review is to report the state of the art of intra-operative ultrasound as an operative tool to improve localization of small renal masses partially or completely endophytic during robotassisted partial nephrectomy (RAPN). Material and methods: We performed a literature review by electronic database on Pubmed about the use of intra-operative US in RAPN to evaluate the usefulness and the feasibility of this procedure. Results: Several studies analyzed the use of different US probes during RAPN. Among them some focused on using contrastenhanced ultra sonography (CEUS) for improving the dynamic evaluation of microvascular structure allowing the reduction of ischemia time (IT). We reported that nowaday the use of intraoperative US during RAPN could be helpful to improve the preservation of renal tissue without compromising oncological safety. Moreover, during RAPN there is no need for assistant to hand the US probe increasing surgeon autonomy. Conclusions: The use of a robotic ultrasound probe during partial nephrectomy allows the surgeon to optimize tumor identification with maximal autonomy, and to benefit from the precision and articulation of the robotic instrument during this key step of the partial nephrectomy procedure. Moreover US could be useful to reduce ischemia time (IT). The advantages of nephron-sparing surgery over radical nephrectomy is well established with a pool of data providing strong evidence of oncological and survival equivalency. With the progressive growth of robot-assisted partial nephrectomy (RAPN) techniques, the use of several tools has been progressively developed to help the surgeon in the identification of masses and its vascular net. In this short review we tried to analyze the current use of intra-operative ultrasound as an operative tool to improve localization of small renal masses partially or completely endophytic during RAPN.
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